All About Varicose Veins

Laser/Pulsed Light Therapy

Relatively new in the treatment of varicose veins, light energy can also wither a vein from the inside, leaving scar tissue that is eventually reabsorbed. Lasers can be adjusted to emit a single wavelength, or "color" from the light spectrum, and so can be targeted at areas that will absorb that color, leaving surrounding tissues unharmed. A beam of light that targets the bluish hemoglobin in oxygen-depleted blood heats the blood in the varicose vein, scalding the vein itself. Since lasers cannot penetrate the skin very deeply, this technique is only effective on veins close to the surface of the body.

Ambulatory Phlebectomy

Also most effective on veins near the skin surface, this procedure actually removes the varicose vein and can be performed in a doctor's office using only local anesthesia. The vein is viewed under a special light source that makes it stand out clearly, and the doctor makes a series of small needle punctures through which the vein can be grabbed and pulled out with a tiny hook.

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Stripping/Ligation

To remove veins that are not near the skin surface, this procedure is generally performed by a vascular surgeon and usually requires general anesthesia. An incision is made to access the vein, and it is either removed or tied-off so that it will shrivel and eventually be reabsorbed. After recovery from the anesthesia, tenderness in the area from which the veins were removed can last for days or even weeks."

Finding Closure for Varicose Veins

In the Spring of 1999, Susan Carroll of Timonium, Maryland, was becoming frustrated by her varicose veins. "Cosmetically, it was not a pretty sight," she recalls. "I am active in sports and I was very aware that people were probably saying, 'why doesn't she do something about those horrible legs?' She had tried sclerotherapy several times, but her varicose veins kept coming back. She was hesitant about undergoing the anesthesia and trauma of stripping. Then she learned about a new procedure called "closure" which had just been approved by the FDA.

Combining many of the benefits of existing procedures, closure involves making one small incision above the knee, through which a slender catheter is threaded down into the defective vein. Once in place, the catheter delivers radio-frequency energy. Dr. Weiss, one of the developers of the technique, explains, "This radio-frequency energy goes through the wall of the vein and it actually causes the collagen to vibrate and heat up, and when collagen heats up, it contracts, so you actually shrink the vein from the inside."

The procedure can be performed in a doctor's office using only local anesthesia, and can be used for both surface and deeper veins.

After undergoing the treatment in Dr. Weiss's office, Carroll reported, "It was very simple. It didn't even take an hour to do and the recovery period was nil. I was up and out of there immediately and I had very little pain. Very, very little."

On a follow-up visit, Carroll's treated vein showed no sign of blood flow, indicating the procedure had worked. "We've been doing this for about a year now," says Dr. Weiss, "and closure has worked in every single case. In worldwide studies, there's been a 95 percent success rate."

Dr. Weiss expects the closure technique to become the "gold standard" for treating varicose veins, but because it is still so new, many insurance companies have yet to approve it for coverage. Susan Carroll, however, needs no more convincing. "I'm just glad that something is out there like this," she says, "I would definitely recommend it to my friends.